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John Miall Risk Manager City of Asheville, NC. Asheville Diabetes Disease Management Project. The Asheville Project. Diabetes-Related Comorbidities. 2–4 times greater risk of heart disease 60–65% have hypertension 2–4 times greater risk of stroke

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john miall risk manager city of asheville nc
John MiallRisk ManagerCity of Asheville, NC

Asheville Diabetes

Disease Management Project

diabetes related comorbidities
Diabetes-Related Comorbidities
  • 2–4 times greater risk of heart disease
  • 60–65% have hypertension
  • 2–4 times greater risk of stroke
  • 60–70% have some degree of nervoussystem damage
  • Leading cause of adult blindness
  • Leading cause of ESRD* (40% new cases)
  • >50% lower limb amputations

* End-Stage Renal Disease

diabetes related indirect costs
Diabetes-Related Indirect Costs
  • 8.3 sick-leave days annually
  • 1.7 sick-leave days for employees without diabetes
  • $47 billion in productivity forgone due to disability, absence, and premature mortality
patient incentives and care model
Patient Incentives and Care Model
  • Patient selection / recruitment
  • Patient education — Mission + St. Joseph’s Diabetes Center
  • Matching patients to pharmacists
  • Incentives:
    • PBM* co-pay waivers
    • Labs without co-pays
    • Glucose meters
  • The operative word in pharmaceutical care is “care” (Madge testimonial)

*Pharmacy Benefit Manager

how they do it
How They Do It

“Patient making better food choice. Blood glucosemuch improved. 2 x 1.5c cm wound RLE. Referredto physician for evaluation and therapy.”

city of asheville medical costs
City of Asheville Medical Costs

Average annual aggregate medical claims

*including prescription drugs for diabetes

quality of life
QUALITY OF LIFE
  • Baseline
  • At 14 Months into program

Source: SF-36 Form

frequency severity matrix
Frequency/Severity Matrix

Severity

High FrequencyLow Severity

High FrequencyHigh Severity

Frequency

Low FrequencyLow Severity

Low FrequencyHigh Severity